| NPI | 1437445541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CA LPCC6517) |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2020-02-26 |